Individual provider Active NPI

Nadine Joye Waeghe, M.P.T., A.T.C.

  • Athletic Trainer
  • Redwood City, CA
National Provider Identifier
1346317732
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
2575 E Bayshore Rd
Redwood City, CA 94063-4117
Phone
(408) 888-1641
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Primary
Sports Physical Therapist 2251S0007X 37792 CA

Addresses

Primary practice location

2575 E Bayshore Rd
Redwood City, CA 94063-4117

Mailing address

1139 McKinley St
Redwood City, CA 94061-2124
Phone (408) 888-1641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
37792CAMDLicensed Psychiatric Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1346317732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 MCKINLEY ST",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940612124",
            "telephone_number": "408-888-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 E BAYSHORE RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940634117",
            "telephone_number": "408-888-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAEGHE",
        "first_name": "NADINE",
        "middle_name": "JOYE",
        "name_prefix": "Ms.",
        "credential": "M.P.T., A.T.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "CA",
            "license": "37792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.